[Congressional Record (Bound Edition), Volume 146 (2000), Part 18]
[Extensions of Remarks]
[Pages 26154-26155]
[From the U.S. Government Publishing Office, www.gpo.gov]



MOTION TO INSTRUCT CONFEREES ON H.R. 4577, DEPARTMENTS OF LABOR, HEALTH 
AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS 
                                ACT 2001

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                               speech of

                            HON. JOE BARTON

                                of texas

                    in the house of representatives

                       Tuesday, October 31, 2000

  Mr. BARTON of Texas. Mr. Speaker, I rise today to oppose this motion. 
It is fitting this motion was brought on October 31, because this is 
pure Halloween politics by the minority party designed to scare 
Americans a week before the Presidential election. The timing of the 
motion, and the study upon which this motion is based, are questionable 
at best. One week before an election, the Minority Staff of the 
Government Reform Committee releases a report criticizing the condition 
of Texas nursing homes.
  Some have tried to pass this study off as non-partisan. I have a hard 
time believing such a claim. This study was conducted unbeknownst to 
the majority staff at the Government Reform Committee. This was not an 
effort to accurately gauge the conditions of Texas nursing homes. This 
was purely political. The Gore-Lieberman website posted the study and 
commentary on it before it was released to Majority Members of the 
Government Reform Committee. It also breeds suspicion that days before 
this report was released, the Democratic National Committee began an 
advertising campaign on the state of nursing homes in Texas.
  If this was a non-partisan study then are we supposed to believe that 
it was a mere coincidence the study was released on the heels of these 
ads being run. Even if we are to blindly accept such a coincidence, the 
release of the study to the Gore-Lieberman campaign before it was given 
to Majority Members of the Government Reform Committee clearly 
demonstrate that this study was nothing more than partisan political 
propaganda.
  More disheartening than the timed release of this study was the facts 
ascertained and the conclusions reached by the study are a clear 
misrepresentation of the conditions of nursing homes in Texas. I agree 
that we must take steps to improve the care that patients receive in 
nursing homes. However, as a Texan I take great umbrage at this one-
sided hatchet job designed to embarrass my state.
  If we look at the objective facts we find a much different picture of 
Texas nursing homes than painted by the Minority Staff Report. In 
September 2000, the non-partisan General Accounting Agency (GAO) issued 
a comprehensive study that directly disputes the claims made in the 
partisan minority report. The GAO concluded that the percentage of 
homes in Texas cited for harm and immediate jeopardy deficiencies were 
half what the partisan Minority study claims.
  The Minority Staff study claims that over 50 percent of the nursing 
homes in Texas had violations that caused actual harm to residents or 
placed them at risk of death or serious injury. According to the 
September GAO report, the percentage of homes with actual harm and 
immediate jeopardy deficiencies from January 1997 to July 2000 were 
only 25 percent--half what the Minority report stated. We must work to 
reduce this number, but it also clearly demonstrates how the Minority 
report attempted to overstate the problem in a partisan effort to 
embarrass Texas.
  The University of California San Francisco Department of Social and 
Behavioral Sciences conducted a nationwide study of nursing facility 
deficiencies in which Texas nursing homes rated better than most other 
states. The study examined the percentage of nursing homes with 
deficiencies in ten different areas; Comprehensive Assessments, 
Accident Prevention, Housekeeping, Dignity, Physical Restraints, Food 
Sanitation, Accidents, Quality of Care, Pressure Sores, and 
Comprehensive Care Plans. In Calendar Year 1998, the last year of the 
study, Texas nursing homes had lower indices of deficiencies than the 
normal average in eight of these categories.

[[Page 26155]]

  In the percentage of Quality of Care deficiencies, Texas nursing 
homes are below the national average, while a state like Connecticut is 
a staggering 19 percent above the national average, and above the 
national average in four of ten categories. In the percentage of Food 
Sanitation deficiencies, Texas is half a percentage point above the 
national average. However, Tennessee is over eight percent above the 
national average in Food Sanitation deficiencies. Instead of attempting 
to misrepresent the Texas record for political gain, the Gore-Lieberman 
ticket should be focusing their efforts on improving nursing home 
conditions in their home states.
  In Texas we understand there are problems within our nursing home 
system, and we have taken steps to correct them. In 1995 and 1997, 
Texas passed legislation that instituted: new requirements for 
background checks on nursing home operators, new enforcement measures 
on non-compliant nursing homes, and mandated standards for quality of 
life and quality of care. A facilities compliance with these standards 
must be made available to the public and explained to nursing home 
residents as well as their next of kin.
  According to a March 1999 GAO report on nursing homes, Texas spends 
more than other states on compliant expenditures per home. It also 
shows that the only state with more compliant visits per 1,000 beds is 
Washington. Many experts believe that compliant investigators are more 
important than the standard surveys required not less frequently than 
every 15 months. This is believed to be this case because complaints 
can be a good indicator of a current problem in a facility, that a 
compliant visit comes as a surprise and thus gives surveyors a more 
accurate picture of what is going on in a facility.
  We passed the Boren Amendment in the Balanced Budget Act of 1997 to 
remove states Medicaid spending from the crippling effects of court 
mandated reimbursements. The Boren Amendment was enacted to provide 
more fiscal discipline in the Medicaid program. However, the vague 
wording of the amendment subjected states to numerous court orders that 
led to Medicaid spending spiraling out of control. A major proponent of 
eliminating the Boren Amendment was President Clinton. The President, 
in an August 1999 speech to the National Governors Association, stated, 
``We've waived or eliminated scores of laws and regulations on 
Medicaid, including one we all wanted to get rid of, the so-called 
Boren Amendment.'' Eliminating this provision was a bipartisan effort 
which both parties agreed to.
  If the Boren Amendment is not working, and the proof is not there 
that it isn't, then let's follow the procedures dictated by the 
Balanced Budget Act of 1997. In this statue a provision was included 
that asks the Secretary of the Department of Health and Human Services 
to conduct a study on access to, and quality of, the services provided 
to beneficiaries subject to the rate setting method used by the states. 
That report is due 4 years after the enactment of B.B.A. 97 which puts 
us in August of next year. This report will give accurate information 
on the effects on repeal of the Boren Amendment, and if there is a need 
to have it reinstated.
  This is Halloween, but don't be fooled. If we need to reexamine the 
repeal of the Boren Amendment let's wait until the Secretary is done 
with the report. This motion is not about patient care. This is about 
election year politics, and I urge all my colleagues to vote ``no.''

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